Battle of Ideas 2010, Lunchtime debates, Royal College of Art, London
Dr Christian Fiala, medical director, abortion and family planning clinic; founder and director, Museum of Contraception and Abortion
David J. Nolan, director of communications, Catholics for Choice, Washington DC
John Wyatt, professor of ethics and perinatology and honorary consultant neonatologist, University College London
Chair: Ann Furedi, chief executive, British Pregnancy Advisory Service
The right of doctors and nurses to refuse to perform procedures like abortion on grounds of conscience is well established in Europe and the US. Particularly in America, however, there is concern that there has been a proliferation of healthcare refusals based on âideological and political justificationsâ. It has been widely noted that the concept of âconscientious objectionâ has expanded beyond its original intention. âConscienceâ has been appropriated by entire institutions, such as Catholic hospitals, and applied to a wider range of healthcare procedures, for example doctors refusing to give fertility treatment. In the UK too there have been concerns about pharmacists refusing to issue patients with medication prescribed by their doctors, and questions about whether professionalsâ religious beliefs are accorded too much protection at the expense of patients who do not share those beliefs and simply want treatment. In Britain, however, some religious people suggest it is secularists who are driven by ideology, refusing to accommodate healthcare professionalsâ moral qualms even when patients could easily receive treatment by alternative means.
It is argued that the expansion of refusal clauses could seriously limit access to healthcare. Consequently, some suggest prioritising womenâs 'right to health' over and above healthcare professionals' conscience. But does this risk compromising a doctorâs personal sense of integrity? What might be lost by pushing health professionals to practise against their beliefs? And is it acceptable in a free society to require institutions to conduct procedures that run counter to their values? If it's unreasonable to expect an abortion clinic to employ a priest as an abortion counsellor, why is it reasonable to expect a Catholic hospital to perform abortions? But then, given that abortion is established as a legal right, should physicians be allowed to opt out at all?
We are familiar with increasing employment controversies in the UK where people cite their religion when refusing to do aspects of their job, whether conducting civil partnerships or serving alcohol at supermarket check-outs. Lord Justice Laws, rejecting Christian Gary Macfarlaneâs challenge against his sacking for refusing to give sex therapy to homosexuals, said legislation to protect views held purely on religious grounds could not be justified, noting it was not only an irrational idea, 'but it is also divisive, capricious and arbitrary'. Former Archbishop of Canterbury Lord Carey angrily replied that, 'It isâ¦but a short step from the dismissal of a sincere Christian from employment to a religious bar to any employment by Christians'. What does conscience mean anyway, and what are its limits in public provision of services and employment?